No more visitors EVER! - page 8

Well I had a hell of a night in OB, a sullen rude labor patient even after the epidural, and whining about keeping the moniter belts on- yes they HAVE to be there. Her SO pissed and moaned about it... Read More

  1. by   zyanya
    Grrr - posted a response only to have my ISP dump me. This one will be shorter.

    Yes, I had to come back and read the flaming.

    Yes, I really am an RN. I was offered, in passing, a day shift charge position in the ICU shortly before I left.

    In fact, I'm considering looking into returning to acute care, only closer to home. At least for a couple of years.

    On retrospect and rereading the thread, I was wrong to make the McDonald's analogy. I apologize. However, I stand by my opinion that "shooting most families", having nurses on duty packin' Uzis, referring to ethnic and/or religious groups' BO and several other choice comments I didn't write down to mention is out of line and that it doesn't belong on a public forum. I meant no offense to the people that didn't say things like this or that didn't resort to caustic sarcasm and stereotyping. My apologies to ya.

    I was pleased to see one person respond that my post made him/her rethink incorporating compassion into his/her practice. Makes the flames worth it.

    And just for the record, this "text book" ivory tower attitude has served me well. Exactly 1 yr in ICU and not ONCE did any visitor ever refuse to leave, move or do anything that I'd asked them politely not to do and explained why it was important. Maybe I was just lucky, maybe times have changed or maybe there's something to my "recruit family" policy.

    Again, my apologies for the harshness.
  2. by   SmilingBluEyes
    HEY, like Heather said: when you finally DO make it back to bedside care *aka* as the "real world", you will see things very well may have changed and RADICALLY. While I agree, making comments that suggest racism, making fun of people's backgrounds/natures or "BO" is not nice, but this is a venting going on here!!!!....and they are not doing this in front of the people involved. No names are used or locations, as you can clearly see. It is "supposed" to be a "safe" place to come and be able to dump when it all gets to be too DAMN much. (which is increasingly often in many arenas)......

    Then along come folks like you to pontificate and try to make us feel guilty for trying to vent off bad feelings and stress in a VERY appropriate manner. (rather than going "postal" at work or at home w/our families.) I took exception to what you did here, and still do. You really DO seem to exist in another century or "something"........

    I appreciate your desire to be compassionate and caring to all patients and family, but I believe the VAST majority of nurses who post here hold to the same standards of professionalism where they work Hang around and you might see and actually LEARN something. Can you not see, if not for venting, some might not be able to go on???? Can you see the difference here?

    Good luck when you return to bedside nursing, if you ever really do. Hope you find things the "wonderful" way YOU left them in the ICU. If it gets to be too much, (and it will I wager); don't worry, we will be here if and when it's YOUR turn to vent off steam. Meantime, hope you like the feel of that heavy asbestos suit and hood, honey, cause you are going to continue to attract flames here and for damn good reason. :angryfire
    Last edit by SmilingBluEyes on Aug 13, '02
  3. by   rstewart
    Originally posted by zyanya
    Well, I can't say I've been in an acute care setting in 5 years but quite frankly, I'm appalled reading this... Have things changed so much that this is justified? Granted this is a nursing board and rants are expected...

    I came here after running a Google search on the Nurse Reinvestment Act and decided to peek at these boards and I sat here with my jaw hanging. I am perfectly appalled at the attitudes here. And this a public place where anyone can read this! Quite a few of the situations described were handled well and I understand the frustration but the image this sends out is horrid!!!

    5 years ago I worked in an ICU with no visiting hours. In theory, it was 7A-7P but often visitors were in attendance whenever they choose to be, so I know what lots of visitors were like 5 years ago, and quite well.

    Has anyone here ranting so much thought to give a first time visitor a tour? Explain a little of what's going on?

    OK, your husband is on a breathing machine because he isn't breathing well enough on his own to keep his body going. Don't panic if it beeps, he may just be coughing and the machine doesn't quite know how to take it. (fold back sheet gently and show central venous line) He's getting his fluids and medications through this line. One line is simply giving him fluids. One line has a medicine to keep his blood pressure up. I'll be coming in to add in medicine for infection and to keep all these medicines from tearing up his stomach. (show ECG monitor lines and pulse ox monitor) These pieces of equipment allow us to see how he's doing even when we aren't in the room. If things start beeping, we'll be coming in to see what's going on. Feel free to ask someone running around outside if it's okay if no one appears. What we're watching for is signs that his infection is going away. It may look worse soon. When the antibiotics start working, they will kill the bugs making him sick but when the bugs die, they release more poison so it may look worse. There's always the possibility that we haven't started this in time; he may not make it and that's one reason that I think you should be here. He may not respond to you but research has shown tht the sense of hearing is one remains longer than anything else. Stay here and talk to him. If something goes wrong, we need to be able to get to all this equipment. There's a chair over there where you can sit while I do what needs to be done. If something goes terribly wrong, a lot of people are going to come in here and we may ask you to leave; please trust that we will do everything we can to help him if this happens...

    Takes 5 minutes....

    Sure, some families are annoying but they are also human, they are afraid and they are helpless in the face of the potential death of a loved one. Sometimes "gawkers" come in but by performing this simple ritual, you often gain the support of someone within the family who will call the shots for you. They can tell the other family members and visitors where to sit, when to leave, when to be there. Sometimes, you have to pick a more aggressive family member to performt his function but it works well.

    You'd be amazed what it does for your reputation both in the unit and with families. I've had patients code on MY shift and been the only nurse not threatened (very dramatically, I might add) with a lawsuit.

    This may be more appropriate to a critical care or end of life discussion rather than one on L&D, which I will admit I am ignorant of, and I'm sure some of you do this for your patients and their visitors, which is great.
    I'm sure I managed to peg a rant session and not the typical conversation among nurses nowadays..
    At least I hope so because this thread in general sounds like McDonald's cashiers *****ing about people ordering McWhineBurgers and not like professional nurses. I'm also quite certain my comment will make me an object of derision on this forum very quickly but I don't f******g care!! Have some compassion! And don't forget you represent ALL of us when you speak this way. I ENJOYED many of my patient's families and laughed and cried with them, depending on the situation.

    If anyone not involved in nursing and is reading this, pleas ebe aware that we do not all hold this disdain for visitors and for all nursing students reading this, take my word for it, you'll be glad you did.

  4. by   mark_LD_RN
    Zyanya good luck on your return, I think you are in for a rude awakening! things have changed . i still love being a nurse and caring for my patients i even like visitors. but they have become much more demanding,inappropriate and often expect much more than is avalable. the visitors i have talked about here have made things very dangerous and inappropriate. they have no respect for patients rights or privacy. birth has become americas number one spectator sport!

    well good luck anyway,comeback and let us know how wonderful it is in your world in ICU.
  5. by   rncountry
    Zyanya, you miss the point. The point is that visitors that behave this way compromise and at some points threaten patient care. If you can't get to the bedside in an emergent situation because of visitors who are, at times, purely ignorant, whose fault is that in a court of law? Do you want to be the nurse in a lawsuit or under investigation by the state board related to an incident in which patient harm resulted directly related to visitors? How exactly would you explain that situation? "I'm sorry the baby died, but I couldn't get the family out of the way in order to properly assess and intervene?" The idea that nurses are there to not only care for the patient, but every Tom, Dick and Harry that walks in the door is actually a fairly new concept. I would also like to point out that an ICU enviroment is a far cry from a busy med surg floor, or an OB floor. I know I've worked both ICU and med surg. 5 years ago there was supposedly a glut of nurses too, or at least the amount of layoffs of nurses would have one believing that. Today's enviroment is a much different place. You are out of line to come in giving text book lectures to nurses who work it and bring it home on a daily basis when you have not been at the bedside for the number of years that you have been doing whatever else you are currently doing.
    Today had a child about 7-8 years old visiting grandma with his mother. When I walked into the patients room to do a dressing change on the room mate the kid is walking on the window ledge. The windows are about 5' tall and 6' wide. Mom is talking to grandma, grandma is telling the kid to get down, mom is ignoring the kid and kid is ignoring mom. I nicely ask the young man to get off the window sill, it is not safe. He looks at me like I am bubblegum on his shoe. Mom continues to ignore his behavior. I then walk over in front of his mother, and ask her to please have her child get off the window sill. Her response is that he is not hurting anything. I explain that I do not believe this is a safe situation, noting we are on the 6th floor. Kid then says I wouldn't fall all the way there is a building below here. True, three stories down, part of the building sticks out. I turn around tell him I don't care and physically pick him up and sit him in a chair. At which point he starts screaming at me. Mom is just looking at me. I tell her that I would be happy to go get my manager if she feels she would like to talk to her. Her response? Well I guess he shouldn't be up there anyway! What a moron! Grandma wants to die with embarrassment.
    I do not and will not put up with being treated poorly, not by anyone. Last week while I am on the phone with a physician a patient came to the nursing station and began yelling at me because I had removed his binder the day before because it was highly soiled and placed another one. Patient said it was too tight so I ordered another binder up from supply. It did not come before my shift was over. I need to explain I am a wound nurse, this patient had staples with surgical wound well approximated, but a great deal of drainage. Normally I would not be seeing this type of patient but was doing so only because his primary physician had specifically requested that I find something to handle the drainage. I could have done so and then had the primary nurse do the dressing, but had opted to do them myself so I could assess if the product I had chosen was working. Anyway, the upshot was the binder came up about half an hour after I left and was put on by the primary nurse. Before I left I had educated the patient on how to splint his abd. with a pillow when coughing etc... all appropriate education was done with this patient Zyanya. What the result was is him standing at the nursing station yelling so loudly about the complaint he was going to file against me that the physician I was talking to asked me who was yelling, he could hear every word. I asked the physician if he could hold. so I could switch to a different phone and continue giving the doc what was happening with his patient. I then moved into the conference room while ignoring the ranting patient. I got new orders for the patient I was discussing then went out to confront the ranting man, who had went to his room. I requested his primary nurse accompany me so I had a witness as to what I had to say. I then went into the patient's room and explained to him I was sorry that supply had taken so long to bring up the binder, but that I had no control over supply. I noted that the binder had come up approximately a half an hour after I had left, 45 minutes after the end of my shift already, and that it had been placed immediately by the primary nurse. That left his binder off for approximately 2 hours. I noted the binder was for comfort measures, not so the wound would not dehise. I then noted to him that I had educated him as to what to do when the binder was not on. Asked if I had everything correct so far. He said yes. I said Good, because he needed to understand something, that I would not, nor would I ever take a patient or anyone else yelling at me in the way that he had. I did not allow my husband to treat me that way, nor any physician. His behavior was not only rude, but inappropriate in the extreme. That I have a life outside of my work, with three children and a husband and I did not believe I should have to give up my family time to work over in order to wait for a binder that other nurses certainly had the ability to apply. I then explained that since he was not actually a true wound patient I had decided to exercise my option of not seeing him any further, and would write an order to that effect. With that I left the room while his mouth hung open. I called the physician, explained what had happened and then wrote the order for the primary nurse to do all dressing changes. Then I went down and explained the whole thing to my nurse manager. I am fortunate in that our manager backs her nurses in situations like this. In the morning the patient complained to the phyisician that I had been rude, the physician told him that he had already heard what happened. that he had yelled at me once and I yelled back. So he didn't yell at me anymore and he suggested the patient do the same. And that no I would not be seeing him any longer. The physician took great delight in telling me about the conversation. So you see there are times when you simply must stand your ground and decide you are not a doormat. It is not inappropriate to do so, NO ONE, not even the caring, giving nurse should be expected to keep swallowing even in the most inappropriate situations. To suggest otherwise is to perpetuate the myth that nurses can and will take whatever is dished out, even to the detrimate to our mental and physical wellbeing, not to mention what it can to do our family life.
    About a year ago while still working as a primary nurse I had a patient code while I was in the room, husband hovering at the bedside, asked three times for him to move so I could get to the patient, fourth time I yelled get the hell away from the bed so I can get to her. Vent, IV and tube feeding pump on the other side so I couldn't get to her there. Should I have just educated him that his wife had no heart rhythm and that if he could kindly step away from the bedside I would start chest compressions? Or do I wait and end up in front of a court or the board of nursing while I explain I didn't start a full code because the husband wouldn't move after I asked nice three times? I know he was scared, I know he didn't grasp what was happening, and I also know I had to forcely get his attention in order to handle an emergency situation he was blocking me from being able to do.
    The image of the all giving, all caring nurse shrouded with Florence Nightengale's mantle is one that is too old and outdated in the current working situation. Nurses like you do nothing but perpertuate a myth that is not only harming the nurse at the bedside, but the entire profession because it is driving out nurses from the career field in droves. Exacerbating a crisis that threatens to get much worse before it gets better. The Nurse reinvestment act that you were searching for is not going to do a damn thing until those with the power but not the knowledge get a clue as to what is actually happening. I do not have clients or customers, I have patients. I am not a *****, I am a patient advocate. And I find it impossible to properly advocate for my patients if I don't advocate for the field so that appropriate care of those patients can be done. And by perpetuating a myth of the nurse from the 1880's you not only harm your profession you, by extension, harm patient care.
    Step into my world before you have the audacity to be so critical and lecture any of us on professionalism. Being a professional does not mean laying down while everyone walks on you while you smile and ask can I get you anything else, I have the time.
  6. by   maizey
    Bravo Rn Country. Wonderful examples. Too bad they were all true. They would make a great story.

  8. by   KarafromPhilly
    rncountry, you take my breath away. You are awesome.
  9. by   mark_LD_RN
    rncountry, that was very well articulated!could not have said it better myself.